Tuesday, 27 September 2011

PMS AWARENESS WEEK - THIS WEEK!


This week is PMS AWARENESS WEEK!
Run by NAPS - The National Association for Premenstrual Syndrome, PMS Awareness Week is held to try and bring PMS into the media and into discussion.

This morning, Bo, from PMS Warrior Blog, appeared on a national breakfast show called Daybreak.
You can see the video here http://www.itv.com/lorraine/health/pms-awareness-week/

While PMS is a much more general condition and not as severe as PMDD, it is necessary to raise awareness.  PMS is a woman's first point of call when she realises there is a cyclical nature to her problems and mood changes.  NAPS is the only organisation in the world that tries to give information, support and a voice to sufferers of PMS and PMDD.

Please feel free to use the image above on your Facebook page to help raise awareness amongst your friends and family.  Many women suffer in silence not knowing where to turn.  NAPS is there waiting to offer support and advice.  On their website you will find a free forum, and mood chart, and by joining up as a member, you will be able to gain access to other benefits.

If you blog, please share this information to your readers.  NAPS is a charity, and need everyone to help spread the word.

Point them in this direction!  National Association of Premenstrual Syndrome - www.pms.org.uk


Tuesday, 13 September 2011

SAD Alert! The Serotonin Factor

Serotonin is the body's feel good hormone. It's a neuro-transmitter and it's function depends on the region of the brain into which it is released. For example, the serotonin neurons in frontal cortex of the brain regulates cognition, memory, and perceptions. The serotonin neurons in the hippocampus regulate memory and mood. The serotonin neurons in other limbic areas such as the amygdala also regulate mood.

Low levels of serotonin are accountable for:

Anxiety, depression, panic attacks, insomnia, obesity, fibromyalgia, eating disorders, chronic pain, migraines, alcohol abuse, negative thoughts, low self-esteem, obsessive thoughts and behaviours, PMS, SAD, and Irritable Bowel Syndrome.

The following factors can cause low serotonin levels:
  • Alcohol
  • Artificial sweeteners (aspartame)
  • Caffeine
  • Cigarette Smoking
  • Diabetes
  • Dietary deficiencies of nutrient co-factors
  • Ecstasy, Diet Pills, and certain medications
  • Genetic Predisposition
  • Hormone Imbalances (thyroid, adrenal, estrogen)
  • Hypoglycemia
  • Insulin Resistance
  • Inflammation
  • Infections
  • Poor Diet
  • Lack of exercise
  • Lack of sunlight
  • Problems converting tryptophan to Serotonin
  • Problems with Digestion
  • Stress and Anger
  • High Cortisol Levels

If you can tick a few things on this list, you are;
a) more likely to suffer with Seasonal Affective Disorder
b) not helping your PMDD or PMS

When you read this, it makes some sense of the plethora of symptoms experienced in PMDD.  Low serotonin levels are almost certainly adding to the nightmare of PMDD as women with PMDD will suffer panic attacks, anxiety, and high levels of stress every month, which affect the production of serotonin. At the same time, the fluctuating hormones will mean serotonin is depleted during the second half of the cycle (luteal) phase, adding to the low serotonin symptoms.

Obviously, it is not your fault if you have a hormone imbalance, are hypoglycemic or have a genetic problem, etc, but if you smoke, eat bad foods and don't get enough exercise, you will not be helping your situation. If you would like to read about serotonin in more detail, please go here...

Serotonin and Light



Low light levels during the winter mean that your body doesn't make as much serotonin, which is triggered into production by light. Serotonin is the chemical in our body that helps us feel awake and gives us energy. Light restricts the body's production of melatonin, which does the opposite job to serotonin... it makes us sleepy and brings about a feeling of tiredness so we can rest and sleep at night. If our serotonin levels remain low, that means were are full of the opposite chemical, melatonin, hence the heavy, tired, and lethargic feelings that SAD and PMDD can bring on.

One way light is measured is by using the term 'lux'. An average indoor room lighting is around 50-200 lux, whereas, outside the light levels will be anything from 1000 to 50,000 lux. Lux refers to the intensity of light. It is thought that an average of 2500 lux is needed to keep SAD at bay and encourage serotonin production. Household lightbulbs for instance, do not have the same intensity as The Sun! And it is this light from the Sun our bodies are craving during the winter months.

There are 3 main ways to treat SAD. Light Therapy, SSRI's and Dietary changes.

Light therapy involves sitting in front of an SAD light box for a certain amount of time everyday, usually in the morning. Light boxes can be very expensive, but it can work really well for some people to combat SAD. 10 years ago, my SAD was so severe I invested in a light box. It was a huge cumbersome thing! I found it difficult to use, as sitting for an hour in front of a night is almost impossible when you have a child running around! So now you are more likely to find me outside whenever it is bright or sunny in the winter, just absorbing the sun!
Light enters the body through the skin and eyes (obviously DON'T look direct at the Sun!). Sun screen and contact lenses/glasses will not allow the body to collect what it needs, so make sure you get the light onto your bare skin and spend sometime without contact lenses or glasses outside, whenever there is a sunny spell!

SSRI's (Selective serotonin re-uptake inhibitors) may be necessary for some people, but this should be researched and discussed with your doctor. Taking anti-depressants work for some people, but for others, working on diet and lifestyle will be just as effective. Remember, you should STILL work on these changes even if you are taking SSRI's, you will get more relief if you help your body rather than work against it.

Dietary changes:

Avoid the factors on the list above such as smoking, caffeine and lack of exercise, and incorporate more of the following into your diet.
  • complex carbohydrates 
  • chicken 
  • turkey 
  • tuna 
  • salmon 
  • kidney beans 
  • rolled oats 
  • lentils 
  • chickpeas 
  • pumpkin seeds 
  • sunflower seeds 
  • baked potato with skin 
  • tahini (sesame butter) 
  • walnuts 
  • avocado 
  • almond butter 
  • Eat a variety of fresh fruits and vegetables (organic if possible) 
  • Drink 6-8 glasses of water daily
By eliminating foods and lifestyle choices that will make your SAD or PMDD worse, and increasing the foods above that help boost serotonin, you will have more of a chance of getting through the winter!

Here are a few other things you can do to help yourself through the winter months:  

  • Get plenty of exercise (30 minutes at least three times a week)
  • Eat regularly throughout the day.
  • Get plenty of natural sunlight 
  • Manage stress and negative emotions 
  • Get 6-8 hours of quality sleep a night 
  • Set time aside for fun and relaxation 
  • Take a multivitamin daily 
  • Prayer and Meditation

The winter is fast approaching. September in the UK is one of my favourite months. The leaves change and fall, the wind picks up, the days are changeable and the temperature drops, but we still have some lovely sunshine popping through every now and then.  October brings Halloween and November, Fireworks...  I can usually deal with winter till December  but by then I am struggling (I'm not a Christmas fan!).  I am planning on upping my serotonin levels by eating better and getting outside when ever I can. Putting lights on in the house is also a good move when the days are dreary, and getting a good nights sleep always helps my mood.

Remember, if your symptoms are really bad and you are feeling unstable, low, depressed, maybe even suicidal, PLEASE contact your doctor and get some support. Realise that it is a temporary situation and the wheel is always turning.. it wont be long till spring is here again!

SAD Alert! The dark months are coming


One of the reasons women with PMDD have such a hard time, is because the hormone fluctuations can affect the levels of serotonin in your body. Serotonin is the main factor is Seasonal Affective Disorder.

Seasonal Affective Disorder can translate into winter depression, and is brought on by the lack of light available in some countries during the winter. I live in the UK and have suffered with SAD for over 10 years... quite possibly longer, but I first realised it was SAD after the birth of my first child. In retrospect, that was the same time my PMDD began to get worse.

The following information is taken form the SADA website

SAD (Seasonal Affective Disorder) is a type of winter depression that affects an estimated 7% of the UK population every winter between September and April, in particular during December, January and February. It is caused by a biochemical imbalance in the hypothalamus due to the shortening of daylight hours and the lack of sunlight in winter.
For many people SAD is a seriously disabling illness, preventing them from functioning normally without continuous medical treatment. For others, it is a mild but debilitating condition causing discomfort but not severe suffering. We call this subsyndromal SAD or 'winter blues.' It is estimated that a further 17% of the UK population have this milder form of condition.

SADA's Symptom list is as follows:

The symptoms of SAD usually recur regularly each winter, starting between September and November and continuing until March or April.

A diagnosis can be made after three or more consecutive winters of symptoms, which may include a number of the following:

Depression
Low mood, worse than and different from normal sadness
Negative thoughts and feelings
Guilt and loss of self-esteem
Sometimes hopelessness and despair
Sometimes apathy and inability to feel 
Sleep Problems
The need to sleep more
A tendency to oversleep
Difficulty staying awake during the day and/or disturbed sleep with
very early morning wakening
Lethargy
Fatigue, often incapacitating, making it very difficult or impossible to carry out normal routines
Over Eating
Craving for carbohydrates and sweet foods leading to an increase in weight
Cognitive Function
Difficulty with concentration and memory
The brain does not work as well, or as quickly
Social Problems
Irritability
Finding it harder to be with people
Anxiety
Tension
Stress is harder to deal with 
Loss of Libido
Less interest in sex and physical contact
Sudden Mood Changes in Spring
Sharp change in mood
Some experience agitation and restlessness and/or a short period of
hypomania (over activity)
No dramatic mood change but a gradual loss of winter symptoms


Imagine having that for 4-6 months of the year ON TOP of the monthly PMDD hell.

If you have a worse time during the winter months, then you are probably suffering from SAD. The link between SAD and PMDD is the lack of serotonin being produced and getting to the brain, which is why SSRI's are often prescribed for PMDD and SAD.

Think back to last winter and previous winters... How do you feel during the winter months?
Do you experience more depressive episodes or angry outbursts?
Do you sleep more and have trouble getting up in the morning?
Do you feel relief when the wheel turns to spring?

For more information, please visit the following links.. and talk to your doctor or health professional if you feel you may be suffering from SAD.

http://www.sada.org.uk/

http://www.sad.org.uk/

http://www.nhs.uk/Conditions/Seasonal-affective-disorder/Pages/Introduction.aspx

Look out for my next post on low serotonin and what you can do to help your PMDD and/or SAD.

What is Dysphoria?

One of the distinct symptoms of PMDD is often overlooked. Dysphoria is the key word that differentiates PMS from PMDD. When do you know you are suffering from PMDD and not PMS? When the dysphoria takes over.... It's not called Premenstrual Dysphoric Disorder for nothing!

Dictonary.com describes Dysphoria as:
dys·pho·ri·a [dis-fawr-ee-uh, -fohr-] noun Pathology:
a state of dissatisfaction, anxiety, restlessness, or fidgeting.
Origin: 1835–45; < Neo-Latin < Greek dysphoría malaise, discomfort, equivalent to dys- dys- + phor ( ós ) bearing + -ia -ia              Related forms: dys·phor·ic  [dis-fawr-ik, -for-] adjective
 The Merriam-Webster's Medical Dictionary describes it as:

dys·pho·ria definition Function: n : a state of feeling unwell or unhappy compare EUPHORIA 

These definitions are very vague and something many people can relate to.
Wikipedia's definition is slightly more in depth:
Dysphoria (from Greek δύσφορος (dysphoros), from δυσ-, difficult, and φέρειν, to bear) is an unpleasant or uncomfortable mood, such as sadness (depressed mood), anxiety, irritability, or restlessness, experienced from very short periods of time up to a lifetime. Etymologically, it is the opposite of euphoria.
Dysphoria refers only to a condition of mood and may be experienced in response to ordinary life events, such as illness or grief. Additionally, it is a feature of many psychiatric disorders, including anxiety disorders and mood disorders. Dysphoria is usually experienced during depressive episodes, but in people with bipolar disorder, it may also be experienced during manic or hypomanic episodes. Dysphoria in the context of a mood disorder indicates a heightened risk of suicide.
Dysphoric mania, as described in the Merck Manual of Diagnosis and Therapy, is "prominent depressive symptoms superimposed on manic psychosis." Symptoms include:
  • crying
  • curtailed sleep
  • racing thoughts
  • grandiosity
  • psychomotor restlessness
  • suicidal ideation
  • persecutory delusions
  • auditory hallucinations
  • indecisiveness
  • confusion

NOW we find ourselves in PMDD territory. Many women describe the dysphoria as a feeling of losing their mind, or going mad. All common sense is abandoned, things that were easy a few days ago, now become impossible. The mind is racing, sometimes tears come with the thoughts and painful emotions the dysphoria brings up.

Persecutory delusions are common. This is a feeling of paranoia, the idea that everyone hates you, that no-one believes you, that there is some conspiracy to keep help from you. That maybe you're just imagining it and are therefore a really bad person, or insane... that spiritually you deserve this and you will just have to suffer. Many PMDD sufferers feel like this at the bad times of the month, they can't believe they can't stop this, 'why can't I control it?'. These feelings of persecution can spur crazy reactions. Pushing family and friends away because you don't trust they believe you. Deleting friends on social networks, falling out and arguing with people, or simple closing the door on everyone emotionally, to keep yourself 'safe'. Hide away, they can't get you if they can't find you.... 

The other fear is that because there is no break in symptoms.. many women suffer EVERY month, sometimes twice a month. PMDD sufferers are very aware of the strain they put on the people around them. I know I personally feel like the people around me are going to get so fed up and bored of the eternal cycle that they will give up helping or trying to understand. I don't know if I could handle seeing someone I liked/loved go through this every month.

On the website www.dysphoria.info, they have a page about the definition of dysphoria. What's interesting is their use of describing dysphoria as a 'state of being'.
State of being, can be interpreted as state of existence. It is YOU and how you are at the moment in time. This is why it feels like dysphoria consumes and absorbs you. It is why it feels like you will always feel/be like this, but as all sufferers repeat the mantra 'this will pass' to remind themselves this is a temporary state, it is all too easy to get lost and be unable to feel any shred of normality – or should we say, non-dysphoric state of being.

I think it is important to learn about this part of PMDD. It is the part that causes the most distress. It is the part of the disorder that clouds our capable minds, and set's us off on a spiral of negative thoughts and emotions. Ladies become forgetful, distracted, withdrawn, clumsy, unable to make simple decisions, hopeless, easy to anger, frustrated.... Some can't bear loud noises or anything repetitive. They will almost always, feel like they are causing this, or creating it, or are imagining the symptoms. They will always feel a ton of guilt and be reliving past emotional traumas. The dysphoria traps you, paralyses you and steals a week or two of every month from you. Every month, without fail, the dysphoria hits and women feel guilty for not being able to stop it.

How many of you have thought, read up, or discovered what dysphoria means? Learn about dysphoria, so next time you tell someone you suffer from Premenstrual Dysphoric Disorder, you can explain the dysphoric part. I feel that word gets ignored and is very misunderstood, yet is the key reason this disorder is SO debilitating. When your thoughts are not your own, how can you trust yourself? How can you know you are making the right decisions? How can you know who to trust on the outside if you look within and don't find yourself?

How do you interpret your dysphoria?
What aspects of dysphoria do you experience?
How do you cope with it?
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